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Controversies in Neurology
December 2008

Carotid Stenting for Patients With Coexisting Carotid and Coronary Disease

Arch Neurol. 2008;65(12):1670-1672. doi:10.1001/archneurol.2008.508

The overwhelming majority of stroke events are ischemic, and up to one-quarter of these can be related to atherosclerotic disease of the cervical internal carotid artery.1Carotid stenosis causes ischemic stroke by acting as an embolic source and/or causing hypoperfusion of the ipsilateral cerebral hemisphere. Carotid endarterectomy is an established treatment for preventing stroke associated with high-grade carotid stenosis.2-4Carotid angioplasty with stenting is evolving as an alternative to carotid endarterectomy, particularly in patients who have a higher complication rate with carotid endarterectomy.5,6This article will briefly review the indications and limitations of carotid endarterectomy in patients with coexisting coronary artery disease. Carotid angioplasty and stenting could be a safe and viable alternative in the treatment of these high-risk carotid endarterectomy candidates.

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